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[胆囊和胆管的放射学诊断 - 第2部分:急性和慢性胆囊炎、原发性硬化性胆管炎(PSC)、胆道系统的良性和恶性肿块]

[Radiologic diagnosis of the gallbladder and bile ducts - part 2 : Acute and chronic cholecystitis, primary sclerosing cholangitis (PSC), benign and malignant masses of the biliary system].

作者信息

Helmberger H, Kammer B

机构信息

Zentrum für Radiologie und Nuklearmedizin Nymphenburg, Klinikum Dritter Orden, Menzingerstr. 44, 80638, München, Deutschland.

Kinderradiologie im Dr. von Haunerschen Kinderspital der Radiologischen Klinik und Poliklinik, Ludwig-Maximilian-Universität München, München, Deutschland.

出版信息

Radiologe. 2018 Dec;58(12):1099-1114. doi: 10.1007/s00117-018-0463-8.

DOI:10.1007/s00117-018-0463-8
PMID:30430195
Abstract

Upper abdominal pain, icterus and cholestasis are the symptoms leading to evaluation of the biliary tract. Together with its complications biliary stone disease is the main reason for inflammation of the biliary system. A distinction is made between acute and chronic variants. In chronic bile duct inflammation primary sclerosing cholangitis (PSC), primary biliary cirrhosis (PBC) and more recently IgG4-associated sclerosing cholangitis are of particular importance. Besides benign and tumor-like-lesions, malignant entities as gallbladder carcinoma and cholangiocarcinoma (CCC) in its three locations have to be mentioned. Despite all recent improvements, specificity of bile-tract imaging still remains limited, especially regarding malignant masses. Therefore the final diagnosis is made in many cases by histological analysis.

摘要

上腹部疼痛、黄疸和胆汁淤积是促使对胆道进行评估的症状。胆结石疾病及其并发症是胆道系统炎症的主要原因。可分为急性和慢性两种类型。在慢性胆管炎中,原发性硬化性胆管炎(PSC)、原发性胆汁性肝硬化(PBC)以及最近发现的IgG4相关性硬化性胆管炎尤为重要。除了良性和肿瘤样病变外,还必须提及恶性实体,如胆囊癌和三个部位的胆管癌(CCC)。尽管最近有了诸多进展,但胆道成像的特异性仍然有限,尤其是对于恶性肿块。因此,在许多情况下最终诊断是通过组织学分析做出的。

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本文引用的文献

1
Current practices and future prospects for the management of gallbladder polyps: A topical review.胆囊息肉的治疗现状及未来展望:一篇综述
World J Gastroenterol. 2018 Jul 14;24(26):2844-2852. doi: 10.3748/wjg.v24.i26.2844.
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Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy.初始接受影像引导下胆囊造瘘术治疗的急性胆囊炎患者的临床及手术结局
Can J Surg. 2018 Jun;61(3):195-199. doi: 10.1503/cjs.003517.
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Diagnostic accuracy of MDCT in differentiating gallbladder cancer from acute and xanthogranulomatous cholecystitis.
多层螺旋CT在鉴别胆囊癌与急性胆囊炎及黄色肉芽肿性胆囊炎中的诊断准确性
Clin Imaging. 2018 Jul-Aug;50:223-228. doi: 10.1016/j.clinimag.2018.04.010. Epub 2018 Apr 14.
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Percutaneous Cholecystostomy: Long-Term Outcomes in 324 Patients.经皮胆囊造瘘术:324例患者的长期预后
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Multimodality Imaging, including Dual-Energy CT, in the Evaluation of Gallbladder Disease.多模态影像学检查,包括双能 CT,在胆囊疾病评估中的应用。
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Endoscopic Management of Primary Sclerosing Cholangitis.原发性硬化性胆管炎的内镜治疗
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7
Cross-Sectional Imaging of Intrahepatic Cholangiocarcinoma: Development, Growth, Spread, and Prognosis.肝内胆管细胞癌的横断面成像:发展、生长、扩散和预后。
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8
Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline.内镜在原发性硬化性胆管炎中的作用:欧洲胃肠道内镜学会(ESGE)和欧洲肝脏研究协会(EASL)临床指南。
Endoscopy. 2017 Jun;49(6):588-608. doi: 10.1055/s-0043-107029. Epub 2017 Apr 18.
9
Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis: an Update on MR Imaging Findings with Recent Developments.原发性胆汁性肝硬化和原发性硬化性胆管炎:磁共振成像表现及最新进展的综述
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10
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